This highly focused, competitive renewal application for a Research Training Grant (T-32) is designed to develop physicians as independent clinical scientists in the area of cerebrovascular disease and neurocritical care. Our current training program includes extensive hands-on experience in clinical research and trials within a broad array of NIH-funded, T-2-focused, translational research. Our program includes close mentoring with selection of specific research projects within the first year of the program, well-defined course work, and unique training in the evaluation and treatment of patients with acute stroke and neurocritical care. Our post-doctoral training program has been training neurologists for 22 years and emergency physicians formally for 16 years with the goal of producing academic leaders and clinical researchers in the area of cerebrovascular disease and neurocritical care. The last 15 years of our program have included funding by this T32. Since the initiation of the T32, we have developed a very robust neurocritical care training pathway which we have included as part of this T32 training program. This innovative and multi-disciplinary training model has been advocated by the NIH roadmap and by the NIH-funded Centers for Clinical and Translational Science and Training (CCTST). Our training program is comprised of an extensive network of collaborators and mentors that has resulted in academic productivity among our graduates. Training draws on faculty with expertise in acute stroke therapy and clinical trial methodology/management, genomics, hemorrhagic stroke, animal models and in-vitro models of stroke and vascular physiology, traumatic brain injury, methods of neurocritical care, neuroepidemiology, biostatistics, neuro-interventional therapy (endovascular and surgical), neuroimaging, neurorecovery, neurosonology, neurotechnology development, outcome research, stroke prevention, ethical design of research, HIPAA compliance, and data-base management. New this submission is an additional level of focus on the type of clinical/translational stroke research pursued; we now have pathways for those that intend to pursue designing and implementing clinical trials, and a separate track for those interested in more of the epidemiology/outcomes/genetics path. Individuals trained in our program prior to and during the T32 period have been productive thus far as measured by academic appointments, publications, and subsequent grant awards. This relatively rare T32 program designed for post-doctoral physician scientists performing clinical research is significant and desperately needed value added to the standard stroke clinical training programs that exist today. Potential trainees must have completed a residency in neurology or emergency medicine and must demonstrate a commitment to an academic career in cerebrovascular disease and/or neurocritical care; minority recruitment is emphasized. We are requesting continuing support for up to four post-doctoral positions per year (maximum of two fellows per year for two years of training support).